In my last post I talked about the reasons for why I was worried. Now I want to focus on some solutions.
I love a guideline. They’re often easy to find, full of colourful flowcharts and questions and tell you exactly what to do in a nice simple framework. They remind me a bit of the questionnaires I used to read in Mizz magazine, which told me if I should get a guinea pig and who my celebrity crush was. They work well to tell you the cut offs for when it’s just a bit of tummy pain and when you need to consider gastric cancer.
But there isn’t a guideline for this climate crisis. The impacts are too big to be put into a flowchart, we all carry responsibilities. It just wouldn’t fit into the simple ‘yes’ and ‘no’ to generate actions for doctor or patient, and more importantly there aren’t conclusive answers to get to (if you’re interested yes I did get a guinea pig and of course it was Zac Efron).
So, I set about trying to create my own framework suitable for my GP practice and others like it. The Royal College of GPs (RCGP) was the first college to declare a climate emergency and also divest away from fossil fuels. So, inspired by the work already done by the RCGP’s fantastic green impact for health toolkit and various amazing hospitals with innovative sustainability goals like Guy’s and St Thomas, Barts Health and the Newcastle SHINE project I set about making some key changes.
This isn’t an exhaustive list but it is some key easy changes my busy GP practice felt able to do. Maybe it will inspire others from all walks of life to see if it could be reviewed in their offices, home or further afield!
In 2013 Barts health created ‘operation TLC‘ in which they asked the workforce of 15,000 people to do three things – turn off the lights, turn off equipment not in use and close the doors. Simple. They used influencers and a grassroots approach to encourage people to change their behaviour. It worked and they saved more than £100,000 and stopped the equivalent of 800 tonnes of CO2 emissions in the first year.
I think one of the most interesting points about this research was the driving forces which created change. They decided not to make it about cost saving, people don’t feel emotion towards saving someone else’s money. They sold this strategy to the caring staff of the NHS as the way to look after the best interests of patients. It would reduce noise and disruption, which would impact the quality of life during what can be a vulnerable and difficult part of someone’s life. This is what made people take that extra time to turn off their computers and switch the light off: human touches.
Obviously in GP land we don’t have inpatient stays but we do have buildings that are energy rich in use of heating and electric. Maybe I can’t encourage people that turning off the toaster is going to impact the world, but an extra £500 for the office party or a new ECG machine just might.
Currently our GP practice gets through a lot paper. None of us are double sided printing for all those urgent letters and patient information leaflets (and let’s face it from time to time last minute birthday present vouchers). A quick fix by the IT man/woman and we are going to monitor how much paper and trees we could potentially save. Stay tuned.
There’s also the issue with recycling. Having the right bins, knowing which ones to put stuff in. If you don’t work in the NHS the bin situation can be a real source of anxiety – there’s black ones, yellow ones, orange ones: a whole rainbow to contemplate where to drop that glove you just took off. Taking inspiration from GASP and recomed we are looking into writing to the council for some new bins, switching to recyclable sharps bins as well as publicising a medications and equipment recycling scheme.
Electric car charging points, car sharing schemes, cycle to work initiatives. All these things can look at how organisations can encourage individuals to make changes for their own health and the health of our environment. We have two electric charging points subsidised by the government and are putting posters up to raise awareness.
Other GP practices are supporting change by having electric bikes for home visits and virtual reviews to avoid travel induced emissions from both patients and staff. The possibilities seem endless, but require a degree of infrastructure change which can be a challenge. It’ll be an interesting space to watch.
Does anyone remember the birth of search engines? When Ask Jeeves and Yahoo were the ways we talked about searching. Then “Googling it” became that verb that your gran constantly got wrong and everyone uses it without even really thinking about it. Ecosia is a search engine that works exactly like google but instead of each search paying one of the largest corporations in the world it plants trees! I’m trying to get my practice to change our search engines to Ecosia. If we had the whole of the NHS planting thousands of trees whilst searching “differentials for red rash on scrotum” or another unknown medical curiosity just think what we could achieve.
Meat free Mondays
We all know that diet impacts our health, there’s also HUNDREDS of blogs and articles addressing the issue of dairy and meat being a huge contribution to overall emissions. It’s controversial and plagued with people’s views on why it’s okay they had that steak last week. I’m an environmental vegetarian and trying my best to cut back, I’ll admit to the odd drunken chicken wing. It’s not going to be everyone’s first move into environmentalism, but perhaps asking people to look at their diets and see if change is possible would be a step in the right direction. I’ve been looking into my GP communal fridge in search of the answers and think a meat free day might be a good start.
The NHS pension scheme is meant to be one of the best. It’s also a huge pot of money. I’ve written to NHS pensions with this easy template. In terms of divesting, my practice is looking into where we are spending our money including switching to a green energy supplier so we can fuel change.
Spreading the word
And on a final note, this is a numbers game. It might not make a difference if one person turns off a light when they leave a room, but it does if 15,000 people do. The NHS employs 1.5 million people with over 128,000 in primary care. If everybody was talking a little more, putting pressure on people at the top and inspiring change we could create huge shifts in behaviour.
I think it’s worth saying it is hard work in the NHS, there are other priorities with cuts and austerity, brilliantly discussed in ‘a decade of distraction‘ by the King’s fund. But let’s face the facts – this is a WIN WIN. We could be saving money AND the planet. I’ll just say it again: THIS COULD SAVE THE NHS MONEY, and more importantly changes in behaviour are free. So, I’m trying to do my bit talking about it: on this blog, my instagram @climateGP and in a grand round/primary care managers meeting in the next few weeks. Each time I’ve given a talk I stand there with sweaty palms, more make-up than I’d usually wear to work and imposter syndrome feeling like I have “I’m just a GP trainee don’t find me out” stapled to my forehead. I am absolutely in fear of a question about procurement or models that I don’t know the answer to. But, inspired by other grassroots campaigns, maybe if a few people listen and start the conversation we could revolutionise our health system. One small talk at a time.